Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | A 110340 | CA |
N | 207VE0102X | Reproductive Endocrinologist | MD 422907 | PA |
NPI | 1053466011 |
---|---|
Provider Name | Hui-Chun Irene Su |
First Address | San Diego, CA 92193-2410 |
Second Address | San Diego, CA 92121-2111 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2007 |
Last Update Date | 04/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110340 | CA MEDICAL LICENSE (01) | CA |
F1425240 | DRIVER'S LICENSE (01) | CA |